title: [Value of positive resection margins in patients with pT2 prostate cancer. Implications for adjuvant treatment].
abstract: OBJECTIVE
  To analyse the impact on the recurrence-free biochemical survival of tumour involvement of surgical resection margins in patients with localized prostate cancer (pT2) in the prostatectomy specimen and its implications for adjuvant treatment.
  
  
  METHODS
  Retrospective study of 536 patients with stage pT2 prostate cancer, treated with radical prostatectomy between 1996 and 2007. Subsequent to the prostatectomy, the following variables were collected: Gleason score, pathological stage, capsular invasion, surgical margins and perineural invasion. We performed a univariate analysis and subsequently adjusted it by means of a Cox proportional hazard model (enter method).
  
  
  RESULTS
  21.7% presented positive surgical margins and 20.9% developed biochemical recurrence after a mean follow-up of 57 months. 37.9% of the patients with pathological involvement of the resection surgical margins presented biochemical recurrence against 16% that did not have it (p<0.001). In the multivariate analysis, only the surgical margin (p<0.001) and the Gleason score greater or equal to 8 (p<0.001) behaved as independent biochemical recurrence factors. On stratifying the series according to these two variables, we found that the patients with positive surgical margins and a Gleason score of ≤ 7 have a recurrence probability at 5 and 10 years of 35% and 50% against 74% and 87% in the group with positive surgical margins and a Gleason score of ≥ 8 (p=0.002).
  
  
  CONCLUSIONS
  Patients with pT2 prostate cancer, positive surgical margins and a Gleason score of ≥ 8 will benefit from adjuvant radiotherapy. 50% of the patients with positive margins and a Gleason score of ≤ 7 will not recur, which means that the indication of adjuvant radiotherapy continues to be controversial.
authors.affiliation: Servicio de Urología, Hospital General de México DF, México. rosas_nava_jes@hotmail.com
authors.forename: J E
authors.initials: JE
authors.lastname: Rosas-Nava
authors.forename: F
authors.initials: F
authors.lastname: Herranz-Amo
authors.forename: E V
authors.initials: EV
authors.lastname: Paños-Fagundo
authors.forename: E
authors.initials: E
authors.lastname: Lledó-García
authors.forename: F
authors.initials: F
authors.lastname: Verdú-Tartajo
authors.forename: C
authors.initials: C
authors.lastname: Hernández-Fernández
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000473:pathology* / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery; D000368:Aged; D018572:Disease-Free Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies
chemical_list: D017430:Prostate-Specific Antigen